Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
Clin Pediatr (Phila). 2024 Jul;63(7):921-928. doi: 10.1177/00099228231199001. Epub 2023 Sep 9.
The use of procalcitonin (PCT) has grown over the past decade with increasing reliance on the test to rule out bacterial infection. We retrospectively reviewed the medical records of children <18 years old hospitalized at a tertiary care children's hospital from 2017 to 2019 who had PCT testing performed during their admission. Of 4135 PCT levels collected on 1530 children, 982 (23.7%) were diagnostically low and 1993 (48.1%) were diagnostically elevated. Pediatric intensive care, with 6% of total hospital patients, obtained 41.4% of tests. Thirty-one (2%) patients had an average of 27 PCT levels per patient, accounting for 20% of all tests. Many children had symptoms for which testing is not indicated (eg, skin complaints). The differences in PCT testing by service, inappropriate patterns of repeat testing, and testing performed in patients for whom it is not indicated may identify targets for diagnostic stewardship.
过去十年中，降钙素原 (PCT) 的应用日益增多，越来越依赖该检测来排除细菌感染。我们回顾性分析了 2017 年至 2019 年在一家三级儿童医院住院的<18 岁儿童的病历，这些儿童在住院期间进行了 PCT 检测。在 1530 名儿童的 4135 个 PCT 水平中，982 个（23.7%）诊断为低值，1993 个（48.1%）诊断为升高。儿科重症监护病房（占总住院患者的 6%）获得了 41.4%的检测。31 名（2%）患者的平均每人有 27 个 PCT 水平，占所有检测的 20%。许多儿童有症状，但检测并无指征（例如，皮肤问题）。按科室划分的 PCT 检测差异、重复检测的不当模式以及对无指征患者进行的检测，可能确定了诊断管理的目标。
